Antimicrobial Resistance (AMR) Project

Study Overview
A retrospective analysis conducted by Vital Transformation assessed the direct clinical and economic impact of AMR among hospitalized patients with sepsis, pneumonia, and complicated urinary tract infection (cUTI), finding that the 20-year cost will be $655 billion by the year 2045. The analysis used longitudinal electronic health records from Vanderbilt University Medical Center (2016–2024), covering a cohort of 50,189 patients.
Vanderbilt’s catchment area reflects a broad section of the southern US, with a mix of urban and rural populations, making it unique in being demographically representative of the US at large:

• TN (84%), IN (4%), AL (2%), KY (1%), FL (1%), TX (1%), MO (1%), and rest inclusive of NC–MS–AK–(6%)

Key Findings

Hospital Impact
AMR substantially increases resource utilization. Across the three infections studied, AMR is associated with longer hospital stays, higher costs, and increased readmissions. Hospital stay accounts for approximately 83% of total hospital costs for AMR patients. The study estimates that AMR-related infections currently consume approximately 2 million hospital bed-days annually in the US, potentially increasing to 3.5 million days by 2045.

Clinical Burden
Mortality remains substantial across all indications:

• Sepsis: ~34% mortality
• Pneumonia: ~33% mortality
• cUTI: ~24% mortality

A significant proportion of deaths occur within the first two weeks of infection, highlighting the importance of early and effective treatment.
Also, AMR increases hospital readmission rates associated with these infections by about 1/3 (33%) compared to non-AMR infections. This means that Hospital Readmission Rates increase by roughly 7%-points due to AMR alone.

Implications
AMR represents a growing threat to hospital capacity and healthcare economics. AMR incidence is increasing faster than both population growth and overall infection rates. Without effective interventions and innovative antimicrobial treatments, the US healthcare system could face significant additional capacity requirements and hundreds of billions of dollars in cumulative costs over the next 20 years. The findings suggest a substantial potential economic return for investments in new antimicrobial therapies that reduce AMR-related hospital utilization and costs.

AMR is not only a major clinical challenge — it is a significant and growing driver of hospital costs, bed utilization, and readmissions, strengthening the case for investment in innovative antimicrobial solutions.

This study was funded by a consortium of organizations including The Biotechnology Innovation Organization (BIO), Pfizer Inc., Merck & Co., GSK plc, The Alliance for Aging Research, and the Pharmaceutical Research and Manufacturers of America (PhRMA).